Table 1 Characteristics of the included studies. ICU intensive care unit, SIRS systemic inflammatory response syndrome, TP true positive, FP false positive, TN true negative, FN false negative, ED emergency department, AuROC area under curve, HAP hospital-acquired pneumonia, NR not reported. * within which 15 patients did not have sample available for analysis, † A total of 117 patients were determined with infection, within which 96 patients were bacterial infection, 16 patients were viral infection and five patients were parasite infection. Soluble TREM-1 was used to diagnose bacterial infections in SIRS
Study | Country | Setting | Study Design | Patients | Infection Characteristics | Test Timing | Assay Method | Sepsis Prevalence/Mortality (%) | Cut-off (pg/mL) | Sensitivity/Specificity(%) | TP | FP | FN | TN | AuROC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Aksaray S et al., 2016 [14] | Turkey | Medical-surgical ICU | Prospective consecutive | 90 patients with SIRS | Lung (44.2%) and blood (21%) | Within 24 h of admission | ELISA (MyBioSource, Inc., San Diego, CA, USA) | 57.8 (52)/32.7 (17) | 133 | 71.15/76.32 | 37 | 9 | 15 | 29 | 0.78 |
Barati M et al., 2010 [15] | Iran | Medical and surgical ICU | Prospective consecutive | 95 patients with SIRS, 37 non-SIRS patients as control | Not reported | Upon admission at ICU | Quantitative sandwich enzyme immunoassay (Quantikine, R&D Systems, Inc., Minneapolis, USA) | 54.7 (52 in 95)/NR | 725 | 70/60 | 36 | 17 | 16 | 26 | 0.65 |
Brenner T et al., 2016 [16] | Germany | Surgical ICU and post-operative care | Re-analysis of prospective cohort | 60 patients with septic shock, 30 post-operative control and 30 healthy volunteers | GI tract (53.3%), others (30%) and lung (20%); Gram-positive (26.7%), Gram-negative (26.7%) | At sepsis onset, 24 h, 4 days, 7 days, 14 days and 28 days | ELISA (R&D Systems, Inc., Minneapolis, MN, USA) | 66.7 (60 in 90)/NR | 30 | 98.3/90 | 59 | 3 | 1 | 27 | 0.955 |
Dong Y et al., 2012 [17] | China | Emergency and medical ICU | Prospective | 64 patients with SIRS | Respiratory (60.5%), abdominal (14%) and biliary tract (5%) | Within 24 h of recruitment, day 4 and 7 | ELISA (R&D Systems, Inc., Minneapolis, MN, USA) | 67.2 (43)/32.5 (14) | 95.9 | 76.7/90.5 | 33 | 2 | 10 | 19 | 0.868 |
Gamez-Diaz LY et al., 2011 [18] | Colombia | ED | Cross-sectional study with prospective data | 631 patients with possible sepsis syndrome* | CAP (22%), urinary tract (16%) and soft tissue (16%) | Within 24 h of the first ED evaluation | ELISA (Quantikine, R&D Systems, Inc., Minneapolis, MN, USA) | 65.7 (405 in 616)/13.5 (56) | 134 | 60/59.2 | 243 | 86 | 162 | 125 | 0.614 |
Giamarellos-Bourboulis EJ et al., 2008 [19] | Greece | ICU | Prospective | 69 severely injured patients (ISS > 25) with SIRS, 10 patients with ISS > 25 without SIRS as control group | HAP (79%), acute pyelonephritis (7%) or primary gram-negative bacteremia (14%) | At admission, day 4, 7 and 15; and within 24 h after the diagnosis of any septic complications | homemade enzyme immunosorbent assay | 62.3 (43 in 69)/34.9 (15) | 40 | 56.5/91.7 | 24 | 2 | 19 | 24 | 0.708 |
Gibot S et al., 2004 [20] | France | Medical ICU | Prospective consecutive | 76 patients with SIRS | Respiratory tract (55%), abdominal (22%) and genitourinary tract (11%); 55% gram-negative and 42% gram-positive in 40 microbiological proven patients | Within 12 h after admission | immunoblots | 61.8 (47)/32 (15) | 60,000 | 96/89 | 45 | 3 | 2 | 26 | 0.97 |
Gibot S et al., 2012 [21] | France | ICU | Prospective consecutive | 300 patients with SIRS | Lung (49.4%), abdomen (12.3%) and Genitourinary (11%); positive microbiological documents in 88 (57%) pats, with 55% gram-positive and 45% gram-negative | Within 12 h after admission | ELISA (Quantikine, R&D Systems, Inc., Minneapolis, MN, USA) | 51.3 (154)/26 (40) | 755 | 53.2/86.3 | 82 | 20 | 72 | 126 | 0.73 |
Halim B et al., 2015 [22] | Turkey | Hospitalized patients | Prospective | 74 patients with SIRS | Respiratory tract (39.4%), GI tract (24.2%) and urinary tract (21%); Gram-positive (21.2%), Gram-negative (60.6%) | On day 0 at admission | ELISA (R&D Systems, Inc., Minneapolis, MN, USA) | 44.6 (33)/54.5 (18) | 199.72 | 81.8/73.2 | 27 | 11 | 6 | 30 | 0.826 |
Kofoed K et al., 2007 [23] | Denmark | Department of infectious disease and medical ED | Prospective consecutive | 151 patients with SIRS | Respiratory (60.4%), urinary tract (26%) and GI tract (17%) | At inclusion | Luminex multiplex assay (Luminex corp. Austin, TX, USA) | 63.6 (96 in 151†)/NR | 3500 | 82/40 | 79 | 33 | 17 | 22 | 0.61 |
Latour-Perez J et al., 2010 [24] | Spain | General ICU | Prospective | 114 patients with SIRS | Respiratory (40%), abdominal-pelvis (21%) and urinary (12.5%) | As soon as the detection of SIRS | ELISA (R&D Systems, Inc., Minneapolis, MN, USA) | 63.2 (72)/37.5 (27) | 463.2 | 49/79 | 35 | 9 | 37 | 33 | 0.62 |
Li L et al., 2013 [25] | China | Surgical ICU | Prospective consecutive | 52 post-operative patients with SIRS | 60.5% infected with bacteria, 5.3% with fungi, 28.9% both bacteria and fungi; among 34 patients infected w bacteria, 14 with bacillus, 20 with cocci | Within 12 h after admission | ELISA (R&D Systems, Inc., Minneapolis, MN, USA) | 73.1 (38)/48 (25) | 73.57 | 79/79 | 30 | 3 | 8 | 11 | 0.82 |
Li Z et al., 2016 [26] | China | ICU | Prospective consecutive | 80 patients with SIRS, 25 healthy volunteers | Respiratory (48%), urinary tract (22%) and abdominal (14%) | First day at admission | ELISA (R&D Systems, Inc., Minneapolis, MN, USA) | 62.5 (50 in 80)/30 (15) | 123.5 | 76/76.6 | 38 | 7 | 12 | 23 | 0.862 |
Rivera-Chavez FA et al., 2009 [27] | USA | Surgical ICU | Prospective | 93 patients with SIRS, 15 patients with ISS > 25 without SIRS as control group | Lung (60%), abdomen (13%) and blood (12%); 28 (30%) patients with gram-negative isolation, 22 (23%) with gram-positive isolation, and 6 (7%) with fungus | Within 24-36 h after admission | DuoSet enzyme-linked immunosorbent assay (R&D Systems, Inc., Minneapolis, MN, USA) | 60.2 (56 in 93)/11 (6) | 230 | 98/91 | 55 | 4 | 1 | 33 | 0.97 |
Song X et al., 2017 [28] | China | Department of gastrointestinal surgery | Prospective | 128 SIRS patients after abdominal operation, and 60 healthy controls | Intestinal fistula (23.5%), gastric fistula (19.1%) and ileus (22.1%) | Within 24 h after hospitalization | ELISA (Quantikine, R&D Systems, Inc., Minneapolis, MN, USA) | 53.1 (68 in 128)/21.4 (12) | 113.06 | 80/76 | 54 | 14 | 14 | 46 | 0.82 |
Soud DEM et al., 2011 [29] | Egypt | Surgical ER and ICU of anesthesia | Prospective | 70 trauma patients with SIRS, 10 non-SIRS trauma patients as control group | Abdomen (31.6%), chest (26.3) and urinary (15.8%) | Not reported | ELISA (Quantikine, R&D Systems, Inc., Minneapolis, MN, USA) | 27.1 (19 in 70)/NR | 254 | 94.7/91.8 | 18 | 4 | 1 | 47 | NR |
Su L et al., 2013 [30] | China | Respiratory, Surgical and Emergency ICU | Prospective | 130 patients with SIRS | Pulmonary (83%), post-operative (31%) and urinary tract (24%); Gram-positive (37%), Gram-negative (81%) and fungi (62%) | Within 24 h after admission, and in day 3, 5, 7, 10 and 14 | ELISA (Quantikine, R&D Systems, Inc., Minneapolis, MN, USA) | 76.9 (100 in 130)/43 (43) | 64.4 | 91/89.6 | 91 | 3 | 9 | 27 | 0.978 |
Wang H et al., 2011 [31] | China | ICU | Prospective consecutive | 56 patients with SIRS, 25 non-SIRS as control group | Not reported | Within 24 h after hospitalization | ELISA (Quantikine, R&D Systems, Inc., Minneapolis, MN, USA) | 57.1 (32)/34 (11) | 135 | 93.8/84.7 | 30 | 4 | 2 | 20 | 0.935 |
Yang J et al., 2014 [32] | China | ICU | Prospective | 70 patients with SIRS, 30 non-SIRS as control group | Pneumonia | At day 1, 4 and 7 of admission in sepsis, at day 1 and 4 in SIRS | ELISA (Westang Bio-technology Co., Ltd., Shanghai, China) | 55.7 (39 in 70)/38 (15) | 172.15 | 78.9/82.1 | 31 | 6 | 8 | 25 | 0.796 |